Kornimate/medical-research-clean huggingface dataset:
effects of photobiomodulation in salivary analysis of chronic renal failure patients

Conditions: Xerostomia; Chronic Renal Failure

Summary: end-stage renal disease patients undergoing hemodialysis can present alteration in flow, concentrations and composition of saliva affecting oral health. this randomized placebo-controlled trial aims to evaluate the effectiveness of photobiomodulation therapy (pbm) in salivary parameters in chronic renal failure (crf) patients undergoing hemodialysis. forty-four patients with crf on hemodialysis self-responded two questionnaires for oral health and salivary gland function perception. thereafter, patients were clinically evaluated for the diagnosis of hypofunction of salivary glands and were randomly allocated into two groups: pbm group (n = 21), which received three irradiations of laser at ʎ = 808 nm, 100 mw, 142 j/cm2 and 4 j per point; and a placebo group (n = 17) that consisted of laser protocol with the device switched off. patients were first submitted to sialometry and after to pbm or placebo intervention at baseline, 7 and 14 days. non-stimulated and stimulated saliva were collected for salivary volume investigation and biochemical analysis of total protein, calcium and urea concentrations.


Eligibility criteria:
inclusion criteria: * stable cardiopulmonary and neurological conditions; * hb\> 10.9 g / dl and hematocrit\> 33; * absence of acute systemic infectious processes; * blood pressure \<140 mmhg and pad \<90 mmhg in at least two measurements in two subsequent dialysis; * no hypervolemia; * patients over 18 years-old; * signed a statement of informed consent. exclusion criteria: * patients in intensive care unit; * hemodynamic instability, signs and symptoms of uremic syndrome related to the cardiovascular and neurological systems; * presence of acute systemic infectious processes; * presence of acute cardiovascular disease, systolic blood pressure \> 141 mmhg and / or diastolic blood pressure \> 91 mmhg; * significant anemia (hb \<11 g / dl and hto \<33%); * photosensitivity; * pregnancy.
daily prednisone versus pulsed dexamethasone in treatment-naïve adult patients with immune thrombocytopenia

Conditions: Purpura, Thrombocytopenic, Idiopathic

Summary: patients above age 18 with a first episode of immune thrombocytopenia are randomized 1:1 between 2-4 weeks of daily prednisone (1 mg/kg/d) with subsequent dose tapering (arm a) and six 3-week cycles of pulsed dexamethasone (0.6 mg/kg/d, days 1-4; arm b). the primary endpoint is duration of remission defined as platelets ≥50/nl.

patients above the age of 18 years with a first episode of immune thrombocytopenia (itp) are eligible for inclusion, except pregnant women and patients unable to tolerate glucocorticoids. diagnosis is made and treatment requirement defined according to the 1996 practice guidelines of the american society of hematology. the primary endpoint is duration of remission defined as platelets ≥50/nl. secondary endpoints are response rate, complete remission (platelets ≥150/nl), cumulative cortisol equivalent dose (potency of prednisone / dexamethasone relative to cortisol: x 4 / x 30) and adverse events. during the first week of treatment all patients receive prednisone at 1 mg/kg/d. this period is used to confirm the diagnosis and identify patients with itp secondary to lymphoproliferative, autoimmune (systemic lupus erythematosus, antiphospholipid syndrome) or infectious diseases (human immunodeficiency, hepatitis c, cytomegalovirus infection). patients are stratified by age (cut-off: 50 years), gender and primary versus secondary itp and then randomized 1:1 between daily prednisone (arm a) and pulsed dexamethasone (arm b). in arm a prednisone is continued at 1 mg/kg/d for a second week. if platelets increase to ≥50/nl, its dose is reduced to \<25 mg/d by week 14 and \<7.5 mg/d by week 20 according to a step-wise reduction scheme provided in the protocol. in patients without response after 2 weeks of treatment, the prednisone dose is increased to 2 mg/kg/d for another 2 weeks, then tapered as described above. in arm b patients receive six 21-day courses of pulsed dexamethasone (0.6 mg/kg/d, days 1-4). patients failing to achieve or maintain a remission are switched to the alternative treatment arm (a: no response after 4 weeks of prednisone at 1-2 mg/kg/d, loss of response, maintenance doses exceeding the above limits; b: no response after 2 cycles, loss of response).

Eligibility criteria:
inclusion criteria: * first episode of itp exclusion criteria: * pregnancy * glucocorticoid intolerance
resilience skills self-management for chronic pain.

Conditions: Chronic Spine Pain; Fibromyalgia

Summary: the investigators will conduct a randomized controlled trial of an 8-week resilience-enhanced cbt online self-management program for chronic pain plus usual care (prism), standard e-cbt self-management plus usual care (e-cbt), and usual care alone. thus, 300 individuals with chronic pain will undergo a comprehensive pre-intervention assessment that includes a blood draw (t1). participants will then be randomized 2:2:1 as follows: e-cbt (n=120), prism (n=120) and usual care (n = 60). immediately post-intervention (t2) and at 6 months (t3) and 12 months (t4) after that, participants undergo the same in-person assessment including blood draw. telomerase activity will be assessed at t1, t2 and t3; and telomere length at t1 and t4


Eligibility criteria:
inclusion criteria: * primary back or spine pain diagnosis from the back \& pain center at university of michigan. * high scores on the 2011 survey criteria for fibromyalgia. the survey criteria for fm consist of an assessment of widespread pain and symptom severity. exclusion criteria: * co-morbid autoimmune disorders, including rheumatoid arthritis and systemic lupus erythematosus. * medical conditions that can impair health status independent of spine pain and fm, including cardiopulmonary disorders (e.g. chf, copd), uncontrolled endocrine or allergic disorders (e.g., thyroid dysfunction, type i diabetes), or malignancy within the preceding 2 years * current psychotic disorder (schizophrenia, etc.), dissociative identity disorder, untreated bipolar disorder, active suicide risk, or current alcohol / drug dependence. * planned major surgery in the next 12 months; * pregnancy or taking steroid medications * recent pain interventions ≤6 weeks prior to study (e.g., back surgery, epidural steroid injections) or planned interventions for the study period (e.g., surgery scheduled). ongoing physical therapy will be allowed and new physical therapy or exercise regimen will be addressed during data analysis; * cognitive impairment or dementia (inability to give consent or meaningfully participate); * pending or recently received (within 1 years) pain-related disability or workman's compensation; * unable to read or fluently converse in english; * planning to move from the area in next 14 months; * in the judgment of the pis the individual would not be able to meaningfully participant.
a web-based gentle body stretching to alleviate loneliness and improve mental fitness during covid-19 isolation period

Conditions: Mental Health Issue

Summary: during the covid-19 pandemic, individuals are having to stay at home in quarantine to reduce the risk of transmission of the virus. depending on the number of occupants and the dwelling space available, this can lead to household crowding, which can have an effect on mental health. in addition, the closing of leisure facilities, including restaurants, cafes and, with the need to self-isolate and socially distance, has led to loneliness. the focus on "loneliness" has recently been on a rise, and being described as an epidemic, especially when it has been shown to be associated with various diseases as well as increased risk of mortality. studies conducted on participants in isolation has shown increased mental health issues including anxiety, stress and depression. mindfulness intervention has been shown to alleviate mental health issues including loneliness. however, to date, there is limited studies examining the effectiveness of a remote mindfulness intervention. this proposal aims to deliver a remote mindfulness program that can be accessible by participants easily and even during the isolation period. this intervention will investigate the effectiveness and safety in elevating mental health issues faced by the general population.

loneliness, mindfulness and quality of life will be assessed as the primary outcome of the study. a mindfulness video will be used as the intervention for participants, and is compared with a group with similar video content without mindfulness component. the effect of changes in primary outcome will be assessed between groups after 2-4weeks.

Eligibility criteria:
inclusion criteria: * adult participants exclusion criteria: * none
tai chi as a novel strategy to increase physical activity among adults pursuing metabolic and bariatric surgery

Conditions: Obesity

Summary: the goal of this clinical trial is to evaluate the feasibility and acceptability of a 10-wk hybrid tai chi (tc) program with in-person classes and online tc videos among 24 physically inactive adults who are seeking metabolic and bariatric surgery (mbs) in a single-arm trial. the aims are: aim 1: feasibility: to evaluate whether tc is feasible, defined as a mean attendance rate of ≥70% in-person tc classes attended. aim 2: acceptability: to evaluate whether tc is acceptable, defined as a mean rating of ≥4 across 4 acceptability questionnaire items measured on a 5-point likert scale (e.g., rate "tai chi practice is appealing to me" on a scale from 1 \[completely disagree\] to 5 \[completely agree\]). participants will complete four individual in-person visits where they will complete study assessments and ten weekly group in-person tai chi classes where they will practice tai chi with up to 5 other study participants. additionally, they will be asked to practice tai chi at home with the aid of instructional online videos and log their practice.


Eligibility criteria:
inclusion criteria: 1. seeking to undergo mbs at hhc. 2. be able to give valid informed consent in english. attending the live, in-person, group tc classes each week is the main component of the intervention. during the classes, the tc instructor will be giving instructions and communicating with the participants in english. it is not practical to having an interpreter during the live classes. therefore, participation is limited to those who are english speakers. 3. be 18-70 years of age. 4. have bmi≥35 kg/m2 5. absence of cognitive impairment since participants will need to learn and memorize the tc forms. must score ≥24 mini-mental state examination. 6. be physically inactive defined as performing \<150 min/wk of moderate to vigorous intensity pa based on self-report. 7. be able to ambulate independently without use of an assistive device. 8. be able to complete questionnaires and view tc instructional videos via redcap. 9. be able to commute to one of the hh medical and surgical weight loss center clinics to participate in testing sessions and in-person tc classes. exclusion criteria: 1. having severe psychological or physical conditions that may impair their ability to adhere to the study protocol such as uncontrolled mental health issues, and severe arthritis. 2. pregnant women.
the effects of craving and abstinence from cigarettes on brain metabolism in smokers

Conditions: Nicotine Dependence

Summary: craving and withdrawal from smoking cigarettes are major factors for relapse. we investigated craving for cigarettes in smokers undergoing pharmacological treatment with bupropion (zyban). we compare cue-induced reactivity to smoking videos in smokers who were successfully treated with bupropion to smokers who are still smoking. we measured the brain's metabolic activity in response to smoking and neutral cues in positron emission tomography using fdg.

craving and withdrawal from smoking cigarettes are major factors for relapse. we investigated craving for cigarettes in smokers undergoing pharmacological treatment with bupropion (zyban)for 2 months. we compare cue-induced reactivity to smoking videos in smokers who were successfully treated with bupropion to smokers who are still smoking. we measured the brain's metabolic activity after exposure to videotapes showing smoking and neutral scenes in positron emission tomography using fdg. there were 2 scanning sessions, one with a smoking videotape and one with a neutral video separated by a week. so far we have compared the brain's metabolic activity in 6 abstinent smokers and 6 still smokers.

Eligibility criteria:
inclusion criteria: * cigarette smokers (over 1 pack a day) * age 20-65, male-females exclusion criteria: * dependence on other substances * psychiatric diagnosis * neurological disorder * obesity * young persons * pregnant women

Keywords: craving nicotine imaging fdg pet smoking bupropion
healthy creations: community based lifestyle intervention validation

Conditions: Overweight; Obesity

Summary: there remain important barriers to the translation of the programs like the diabetes prevention program to public health. there is a lack of established lifestyle intervention programs as they are resource and time intensive, exceeding both the resources and the training of most primary care providers. a solution may be the implementation of lifestyle intervention programs in the community setting that are unrelated to primary medical care. a community based program at a public facility may extend the reach of lifestyle intervention to those unable to obtain these services from an established medical facility. community lifestyle intervention to modify dietary, physical activity, and behavioral factors may be a promising strategy for weight management and the reduction of risk for metabolic disease. in this validation study we will assess pre and post intervention to identify whether measurable changes can be detected in body weight, body composition, markers of metabolic disease and quality of life after participation in the "healthy creations", a community based lifestyle intervention program presented by center court fitness center of the grand forks park district and altru health system.


Eligibility criteria:
inclusion criteria: * overweight or class i and ii obese * live in grand forks, nd area exclusion criteria: * history of eating disorder * pregnancy * inability to understand english or give consent * uncontrolled medical condition
trial of adjuvant chemotherapy in breast cancer patients with pathological partial response and complete response to neoadjuvant chemotherapy

Conditions: Invasive Ductal Breast Cancer; Tubular Breast Cancer; Mucinous Breast Cancer; Inflammatory Breast Cancer

Summary: this trial will compare the administration of 2 cycles of paclitaxel and cisplatin (dp) versus 4 cycles of cef as adjuvant chemotherapy for the patients with locally advanced breast cancer and who were pathological partial response to dp as neoadjuvant chemotherapy. those who had pathological complete response to dp will be randomized to have 2 cycles of dp or have no further chemotherapy.

all the patients who had neoadjuvant chemotherapy and had pathological complete response (pcr) or partial response to dp will enrolled in this trial. those who had pcr will randmized to have two cycles of dp as adjuvant chemotherapy or have no further chemotherapy. those patients who had pr will be randomized to have two cycles of dp or four cycles of cef. all the patients with hormonal receptor positive or her2 overexpress tumors are allowed to accept endocrine therapy or anti-her2 target therapy.

Eligibility criteria:
inclusion criteria: 1. women aged ≥18years and ≤70 years; 2. patients with locally advanced breast caner and had weekly paclitaxel and cisplatin as neoadjuvant chemotherapy. 3. patients with pathological partial response or pathological complete response to neoadjuvant chemotherapy according to the response evaluation criteria in solid tumors (recist). 4. endocrine therapy and trastuzumab were allowed to use. 5. ecog 0-2; 6. adequate bone marrow function:wbc≥4.0×109/l, absolute neutrophil count（anc）≥1.5×109/l, platelets（plt）≥100×109/l, hemoglobin（hb）≥90g/l;aspartate aminotransferase(ast),alanine aminotransferase (alt)≤1.5 upper normal limit (unl), creatinine≤1.5 unl, bilirubin≤1.5unl; 7. no obvious main organs dysfunction. exclusion criteria: 1. unwilling or unable to use an acceptable method of contraception in 8 weeks (including 8 weeks) after final dose of test drug; 2. patient is pregnant or breast feeding; 3. metastatic breast cancer; 4. any evidence of sense or motor nerve disorders; 5. patients with medical conditions taht indicate intolerant to neoadjuvant therapy, including uncontrolled cardiovascular disease, severe infection; 6. any concurrent malignancy other than breast cancer; 7. know severe hypersensitivity to any drugs in this study.
cadonilimab plus tace in patients with intermediate-stage unresectable hepatocellular carcinoma

Conditions: Hepatocellular Carcinoma

Summary: cadonilimab is a first-in-class bispecific, humanized igg1 antibody targeting pd-1 and ctla-4, which has the potential to boost immune surveillance in tumors. the goal of this clinical trial is to evaluated the efficacy and safety of cadonilimab combined with tace in patients with intermediate-stage unresectable hepatocellular carcinoma.


Eligibility criteria:
inclusion criteria: 1. written informed consent signed prior to enrolment. 2. age \> 18 years, both sexes 3. patients with histologically or pathologically confirmed intermediate hepatocellular carcinoma; bclc stage b or cnlc stage ii 4. no previous antitumor therapy 5. child-pugh a or b7. 6. with measurable lesions (≥10 mm long diameter on ct scan for non-lymph node lesions and ≥15 mm short diameter on ct scan for lymph node lesions according to recist 1.1 criteria). 7. ecog ps score: 0 to 1. 8. expected survival of \>12 weeks. 9. adequate organ function exclusion criteria: 1. bclc c stage hcc 2. in combined with severe heart, lung, kidney or other important organ dysfunction, or combined with serious infection or other serious associated diseases, that cannot tolerate treatment (\> ctcae version 5.0 adverse events of grade 2). 3. with uncontrolled hepatitis b (hbv-dna\>2000 iu/ml and elevated alt). 4. multi-nodules hepatocellular carcinoma beyond hemi-hepatic range. 5. patients with tumor thrombus reaches or exceeds the portal vein. 6. history of other malignancies. 7. history of allergic reactions to related drugs. 8. history of organ transplantation. 9. pregnant women, nursing mothers. 10. patients have other factors that may interfere with patient enrollment and assessment results. 11. refuse follow-up as required by this study protocol and refuse to sign informed consent.
endomicroscopy, ibs and food intolerance

Conditions: Endomicroscopy; Inflammatory Bowel Syndrome; Food Intolerance

Summary: background: the immediate endoscopic identification and diagnosis of intraepithelial structures and immediate and delayed reactions to allergens in the mucosal surface of the gut are unmet goals in the diagnosis and management of subjects with food intolerances, who are negative to all available tests. endomicroscopy may be helpful to further visualize and characterize unmasked small bowel reactions to foods, which has not been described before. confocal laser endomicroscopy provides confocal microscopic imaging simultaneously to the macroscopic view ,which enables the examiner to see immediate reactions after exposure and it further allows capturing of fluid excreted by the gut for further analysis to understand the pathology behind this reaction further. n=50 patients with unexplained bloating and diarrhoea with suspicion of food intolerance and negative testing with routine methods. patients with lactose intolerance n=10 patients to compare results. patients with fructose intolerance n=10 patients to compare results. volunteers with barrett's esophagus who need evaluation for possible dysplasia in the barrett's mucosa with confocal endomicrosopy but no symptoms of bloating and abdominal pain (n=10) to serve as healthy controls for allergy testing. methods: the primary objective is to investigate whether endomicroscopy will allow the detection of an allergic reaction of the gut after exposure of the 5 major allergens in the following way: after standard gastroscopy with the endomicroscope including evaluation of the surface of the upper gastrointestinal tract, i.v. injection of fluorescein, then initial visualisation of the duodenal surface including count of initial lymphocytes/mononuclear cells in the lamina propria: allergen 1 (milk), allergen 2 (wheat), allergen 3 (soya),allergen 4 (apple), allergen 5 (yeast). the primary endpoint is the visible marked increase of lymphocytes and mononuclear cells in the lamina propria of the duodenum, representing an acute reaction to one of the allergens sprayed to its surface through the endoscope channel.

the primary endpoint is the visible marked increase of lymphocytes and mononuclear cells in the lamina propria of the duodenum, representing an acute reaction to one of the allergens sprayed to its surface through the endoscope channel.

Eligibility criteria:
inclusion criteria: * age \> 18 years * ongoing abdominal symptoms such as bloating and abdominal pain * negative routine testing for food intolerance (or known lactose/fructose intolerance) * written informed consent exclusion criteria: * no consent * known reason for the abdominal pain and bloating other than lactose/fructose intolerance * m. whipple * known infectious gastrointestinal disease * stricture in the upper gastrointestinal tract * age \>18years * impaired renal function (creatinine \>1.2 mg/dl) * pregnancy or breast feeding * inability to obtain informed consent * active gi bleeding * known allergy to methylene blue or fluorescein * participation in other clinical trials within the last 4 weeks
effects of anesthesia type on qor-40

Conditions: General Anesthesia; İnhalation Anesthetics; Quality of Recovery

Summary: to compare the effects of total intravenous anesthesia and inhalation anesthesia used for maintenance on postoperative recovery in patients undergoing septorhinoplasty surgery under general anesthesia, using the recovery quality score (qor-40).


Eligibility criteria:
inclusion criteria: * 18-65 years old * asa i-ii-iii risk group * patients whose consent was obtained with an informed consent form * patients who will undergo septorhinoplasty surgery exclusion criteria: * -asa \>3 * psychiatric illness that prevents them from answering the questionnaire * patients with a history of chronic opioid and benzodiazepine use as it may affect recovery time * severe renal and hepatic insufficiency * severe respiratory and cardiovascular disease * patients with a body mass index \>30 kg m2 * patients with a known history of allergy or contraindication to any of the drugs to be used in the study

Keywords: total intravenous anesthesia anesthesia maintenance inhalation anesthesia quality of recovery-40